Objective To investigate the effect of autologous fat grafting combined with platelet-rich plasma on aesthetic effect in female patients with facial aging. Methods The clinical data of 71 female patients with facial aging who underwent facial rejuvenation treatment in No.2 Hospital of Nanping City and Fujian Medical University Union Hospital from January 2020 to January 2023 were retrospectively analyzed. According to different treatment methods, they were divided into the control group (35 patients) and the observation group (36 patients). The control group was treated with autologous fat grafting, and the observation group was treated with autologous fat grafting combined with platelet-rich plasma. The aesthetic effect, surgical effect, surgical satisfaction and complications were compared between the two groups. Results The aesthetic scores of doctors and patients in the observation group after surgery were higher than those in the control group (P <0.05). The total effective rate of the observation group (86.11%) was higher than that of the control group (65.71%) (P <0.05). The surgical satisfaction score of the observation group was higher than that of the control group (P <0.05). The incidence of complications in the observation group (2.78%) was lower than that in the control group (22.86%) (P <0.05). Conclusion Compared with autologous fat grafting alone, the combination of autologous fat grafting and platelet-rich plasma in female facial rejuvenation surgery can more effectively improve surgical effect, enhance aesthetic scores and patient satisfaction, and improve surgical safety.